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Zentralbl Chir 2005; 130(6): 589-593
DOI: 10.1055/s-2005-918159
Der interessante Fall

© Georg Thieme Verlag Stuttgart · New York

Die nicht-tropische Pyomyositis - ein seltenes Krankheitsbild in gemäßigten Klimazonen

The Non-Tropical Pyomyositis - A Rare Disease in the Moderate Climate ZoneK. Schmidt1 [*] , M. Büter1 [*] , D. Bussen1 , A. Thiede1
  • 1Klinikum der Julius-Maximilians-Universität Würzburg, Zentrum Operative Medizin, Chirurgische Klinik I und II, Würzburg
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Publication History

Publication Date:
29 December 2005 (online)

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Zusammenfassung

Bei einer Pyomyositis handelt es sich um eine in unserer Klimazone seltene akute bakterielle Infektion der Skelettmuskulatur ohne offensichtliche lokale oder benachbarte Infektionsquelle. Zu den initialen Symptomen zählen neben Muskelschmerzen auch lokale Schwellungen und Spannungen. Die Diagnose der Pyomyositis erfolgt in aller Regel verspätet, da oft zunächst andere Ursachen in Erwägung gezogen werden. Anhand dreier Fallbeispiele wird die Diagnostik und Therapie der Pyomyositis vor dem Hintergrund der derzeitig zu diesem Thema verfügbaren Literatur diskutiert.

Abstract

Pyomyositis is in the moderate climate zone a rare and acute bacterial infection of the skeletal muscles without an obvious origin of infection. Initial symptoms contain muscle pain and localized swelling and tension. As different causes are taken into account first, the diagnosis of a pyomyositis is often delayed. We report on three cases of pyomyositis and discuss diagnosis and therapy against the background of the available and recent literature.

Schlüsselwörter

Pyomyositis - bakterielle Infektion - Staphylokokkus aureus - Skelettmuskulatur - multiple Abszesse

Key words

pyomyositis - bacterial infection - staphylococcus aureus - skeletal muscles - multiple abscesses

Literatur

  • 1 Adams E M, Gudmundsson S, Yocum D E, Haselby R C, Craig W A, Sundstrom W R. Streptococcal myositis.  Arch Intern Med. 1985;  145 1020-1023
    CrossrefPubMedGoogle Scholar
  • 2 Ameh E A. Pyomyositis in children: analysis of 31 cases.  Ann Trop Paediatr. 1999;  19 263-265
    CrossrefPubMedGoogle Scholar
  • 3 Andrew J G, Czyz W M. Pyomyositis presenting as septic arthritis. A report of 2 cases.  Acta Orthop Scand. 1988;  59 587-588
    PubMedGoogle Scholar
  • 4 Blatt J, Reaman G, Pizzo P A. Pyomyositis in acute lymphocytic leukemia heralded by cutaneous vasculitis: brief communication.  Med Pediatr Oncol. 1979;  7 237-239
    PubMedGoogle Scholar
  • 5 Caldwell D S, Kernodle G W, Seigler H F. Pectoralis pyomyositis: an unusual cause of chest wall pain in a patient with diabetes mellitus and rheumatoid arthritis.  J Rheumatol. 1986;  13 434-436
    PubMedGoogle Scholar
  • 6 Chacha P B. Muscle abscesses in children.  Clin Orthop. 1970;  70 174-180
    PubMedGoogle Scholar
  • 7 Chiedozi L C. Pyomyositis. Review of 205 cases in 112 patients.  Am J Surg. 1979;  137 255-259
    CrossrefPubMedGoogle Scholar
  • 8 Ellis M, Gupta S, Galant S, Hakim S, VandeVen C, Toy C, Cairo M S. Impaired neutrophil function in patients with AIDS or AIDS-related complex: a comprehensive evaluation.  J Infect Dis. 1988;  158 1268-1276
    CrossrefPubMedGoogle Scholar
  • 9 Ganesh R, Castle D, McGibbon D, Phillips I, Bradbeer C. Staphylococcal carriage and HIV infection.  Lancet. 1989;  2 558
    PubMedGoogle Scholar
  • 10 Gaut P, Wong P K, Meyer R D. Pyomyositis in a patient with the acquired immunodeficiency syndrome.  Arch Intern Med. 1988;  148 1608-1610
    CrossrefPubMedGoogle Scholar
  • 11 Gibson R K, Rosenthal S J, Lukert B P. Pyomyositis. Increasing recognition in temperate climates.  Am J Med. 1984;  77 768-772
    CrossrefPubMedGoogle Scholar
  • 12 Gold H S, Moellering R C. Antimicrobial-drug resistance.  N Engl J Med. 1996;  335 1445-1453
    CrossrefPubMedGoogle Scholar
  • 13 Goldberg J S, London W L, Nagel D M. Tropical pyomyositis: a case report and review.  Pediatrics. 1979;  63 298-300
    PubMedGoogle Scholar
  • 14 Hall R L, Callaghan J J, Moloney E, Martinez S, Harrelson J M. Pyomyositis in a temperate climate. Presentation, diagnosis, and treatment.  J Bone Joint Surg [Am]. 1990;  72 1240-1244
    PubMedGoogle Scholar
  • 15 Horn C V, Master S. Pyomyositis tropicans in Uganda.  East Afr Med J. 1968;  45 463-471
    PubMedGoogle Scholar
  • 16 Jackson D W, Feagin J A. Quadriceps contusions in young athletes. Relation of severity of injury to treatment and prognosis.  J Bone Joint Surg [Am]. 1973;  55 95-105
    PubMedGoogle Scholar
  • 17 Kallen P, Nies K M, Louie J S, Keller M, Worthen N, Bayer A S. Tropical pyomyositis.  Arthritis Rheum. 1982;  25 107-110
    PubMedGoogle Scholar
  • 18 Malhotra R, Singh K D, Bhan S, Dave P K. Primary pyogenic abscess of the psoas muscle.  J Bone Joint Surg [Am]. 1992;  74 278-284
    PubMedGoogle Scholar
  • 19 Mitsuyasu R, Gale R P. Bacterial pyomyositis in a patient with aplastic anaemia.  Postgrad Med J. 1980;  56 61-62
    PubMedGoogle Scholar
  • 20 Mueller P R, Ferrucci J T, Wittenberg J, Simeone J F, Butch R J. Iliopsoas abscess: treatment by CT-guided percutaneous catheter drainage.  AJR Am J Roentgenol. 1984;  142 359-362
    PubMedGoogle Scholar
  • 21 Peckett W R, Butler-Manuel A, Apthorp L A. Pyomyositis of the iliacus muscle in a child.  J Bone Joint Surg [Br]. 2001;  83 103-105
    CrossrefPubMedGoogle Scholar
  • 22 Rodgers W B, Yodlowski M L, Mintzer C M. Pyomyositis in patients who have the human immunodeficiency virus. Case report and review of the literature.  J Bone Joint Surg [Am]. 1993;  75 588-592
    PubMedGoogle Scholar
  • 23 Schwartzman W A, Lambertus M W, Kennedy C A, Goetz M B. Staphylococcal pyomyositis in patients infected by the human immunodeficiency virus.  Am J Med. 1991;  90 595-600
    PubMedGoogle Scholar
  • 24 Smith I M, Vickers A B. Natural history of 338 treated and untreated patients with staphylococcal septicaemia (1936-1955).  Lancet. 1960;  1 1318-1322
    PubMedGoogle Scholar
  • 25 Spiegel D A, Meyer J S, Dormans J P, Flynn J M, Drummond D S. Pyomyositis in children and adolescents: report of 12 cases and review of the literature.  J Pediatr Orthop. 1999;  19 143-150
    CrossrefPubMedGoogle Scholar

1 gleichberechtigte Erstautoren

Dr. med. K. Schmidt

Klinikum der Julius-Maximilians-Universität Würzburg · Zentrum Operative Medizin · Chirurgische Klinik II

Oberdürrbacher Str. 6

97080 Würzburg

Phone: 09 31/20 10

Email: karsten.schmidt@mail.uni-wuerzburg.de

Dr. med. M. Büter

Klinikum der Julius-Maximilians-Universität Würzburg · Zentrum Operative Medizin · Chirurgische Klinik I

Oberdürrbacher Str. 6

97080 Würzburg

Phone: 09 31/20 10

Email: bueter_m@chirurgie.uni-wuerzburg.de

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